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PURPOSE: To report a case of bilateral diffuse uveal melanocytic proliferation associated with renal carcinoma and to illustrate the importance of ancillary examinations to early diagnosis and treatment. DESIGN: Clinical case report. METHODS: A 56-year-old man reported a 3-day history of visual impairment and scotoma in the right eye. An ophthalmoscopic examination, visual field test, fundus autofluorescence, fluorescein angiography, indocyanine green angiography, optical coherence tomography, and systemic evaluation were performed. RESULTS: Fundus examination showed multiple nevus-like uveal pigmented lesions bilaterally. Optical coherence tomography showed a subfoveal serous retinal detachment and focal loss of the retinal pigment epithelium with adjacent areas of retinal pigment epithelial thickening in the right eye, explaining the scotoma on the visual field examination. Indocyanine green angiography showed multiple round areas of hypofluorescence corresponding to the nevus-like pigmented tumors seen on funduscopy, and retinal pigment epithelium damage corresponding to hypoautofluorescence on fundus autofluorescence imaging and window defects points seen on fluorescein angiography bilaterally. After bilateral diffuse uveal melanocytic proliferation diagnosis, a systemic workup showed clear cell carcinoma in the left kidney. Owing to the tumoral size, chemotherapy was administered. CONCLUSION: Renal carcinoma associated with bilateral diffuse uveal melanocytic proliferation is rare, and the patterns observed in the ancillary examinations, including indocyanine green angiography, are useful for early-stage diagnosis and immediate referral for systemic investigation and treatment.

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Objetivo: verificar a existência de afecções oculares, nas primeiras 48 horas de vida de recém-natos, e relacioná-las com a suspeita clínica dos pediatras.Métodos: realizou-se um estudo prospectivo em que todos os recém-natos no período de julho a dezembro de 2000 foram examinados no alojamento conjunto do Hospital Universitário Evangélicode Curitiba (HUEC). Seiscentos e sessenta e sete recém-natos foram avaliados, através de um protocolo, por médicos residentes e preceptores de oftalmologia, independentemente se havia ou não qualquer suspeita de alteração ocular pelo pediatra. Procedeu-se à inspeção,iluminação oblíqua, avaliação de desvio ocular e oftalmoscopia direta à distância (reflexo vermelho) em todos os pacientes.Resultados: em 3,75 por cento dos pacientes avaliados, encontrou-se alguma alteração ocular. A principal afecção ocular foi a opacidade corneana, detectada pelo exame de reflexo vermelho à distância.Cinqüenta e seis por cento dos recém-natos portadores de patologia ocular passaram despercebidos pelos pediatras, neonatologistas e pais.Conclusão: este estudo demonstrou que a maioria das desordens oculares presentes ao nascimento não é diagnosticada pelos pediatras (56 por cento), evidenciando, desta forma, a importância do exameoftalmológico como rotina no atendimento ao recém-nato nas primeiras 48 horas de vida

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OBJECTIVE: To verify the existence of ocular diseases in the first 48 hours of life of newborns and relate it to the clinical suspicious of pediatricians. METHODS: A prospective study was performed. All infants that were born between July and December of 2000 were evaluated in the nursery of Hospital Universitário Evangélico de Curitiba (HUEC). Six hundred sixty-seven newborns were evaluated through a protocol by residents and tutors of ophthalmology, regardless of pediatricians suspicious of ocular disorder. The examination consisted of inspection, oblique illumination, evaluation of ocular deviation and direct ophthalmoscopy (red reflex) in all patients. RESULTS: Among all examined newborns, 3.75% showed some ocular disease. The most frequent problem was corneal opacity. The ocular diseases were not noticed by pediatricians, neonatologists and parents in fifty-six per cent of the cases presenting some problem. CONCLUSIONS: This study showed that many ocular disorders presented at birth are not noticed by pediatricians (56%), which highlights the importance of ophthalmological evaluation in all newborns as a routine examination in the first 48 hours of life.